Occurrence and long-term outcome of tumefactive demyelinating lesions in multiple sclerosis

Background and Objective The presence of lipid-specific immunoglobulin M bands in the cerebrospinal fluid (CSF) predicts an aggressive course in patients with relapsing–remitting multiple sclerosis (MS) during early stages of the disease. This study examined whether it is also a predictor of long-term prognosis in MS. Methods Eighty-one patients with MS and 22 headache controls were analyzed for anti-lipid IgM reactivity in CSF samples. The correlation between the presence of lipid-specific immunoglobulin M bands in CSF and disease progression was assessed in patients with MS who had been followed longitudinally for, on average, more than 11 years. Results Lipid-specific immunoglobulin M bands were detected in the CSF of 24 of 81 patients with MS and were absent in the CSF of all headache controls. Median time to conversion to a secondary progressive course was 11 years in patients with bands and 22 years in patients without bands. Median time to an Expanded Disability Status Scale score of 4 was 14 years in patients with bands and 24 years in patients without bands. Conclusion The presence of lipid-specific immunoglobulin M bands in CSF predicts a more adverse long-term outcome in patients with MS; it may thus define a subset of patients who might benefit from aggressive treatment during the early phase of the disease.

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The Short and Long-term Effects of Pregnancy on Multiple Sclerosis and Experimental Autoimmune Encephalomyelitis

10.20944/preprints201810.0011.v1 ◽

2018 ◽

Author(s):

Pamela McCombe

Keyword(s):

Multiple Sclerosis ◽

Long Term Effects ◽

Childbearing Age ◽

Autoimmune Encephalomyelitis ◽

Term Outcome ◽

Long Term Outcome ◽

Beneficial Effects ◽

Maternal Immune System ◽

Short And Long Term

The role of pregnancy in multiple sclerosis (MS) is of importance because many patients with MS are young women in the childbearing age who require information to inform their reproductive decisions. Pregnancy is now well-known to be associated with fewer relapses of MS and reduced activity of autoimmune encephalomyelitis (EAE). However, in women with multiple sclerosis, this benefit is not always sufficient to protect against a rebound of disease activity if disease modulating therapy is ceased for pregnancy. There is reason to be concerned that use of assisted reproductive therapies can be associated with relapses of MS. It is thought that the beneficial effects of pregnancy are due to the pregnancy-associated changes in the maternal immune system. There is some evidence of this in human studies and studies of EAE. There is also evidence that having been pregnant leads to better long-term outcome of MS. The mechanism for this is not fully understood but it could result from epigenetic changes resulting from pregnancy or parenthood. Further studies of the mechanisms of the beneficial effects of pregnancy could provide information that might be used to produce new therapies.

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Mortality studies for multiple sclerosis: still a useful tool to analyse long-term outcome

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2017-315591 ◽

2017 ◽

Vol 88 (8) ◽

pp. 617-617

Author(s):

Paolo Ragonese

Keyword(s):

Multiple Sclerosis ◽

Term Outcome ◽

Long Term Outcome

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The predictive value of gadolinium enhancement for long term disability in relapsing-remitting multiple sclerosis-preliminary results

Multiple Sclerosis Journal ◽

10.1177/135245850100700105 ◽

2001 ◽

Vol 7 (1) ◽

pp. 23-25 ◽

Cited By ~ 2

Author(s):

N A Losseff ◽

D H Miller ◽

D Kidd ◽

A J Thompson

Keyword(s):

Multiple Sclerosis ◽

Median Number ◽

Short Term ◽

Term Outcome ◽

Long Term Outcome ◽

Relapsing Remitting ◽

Mri Scans ◽

Relapsing Remitting Multiple Sclerosis

As short-term MRI studies are increasingly being used to monitor disease activity in multiple sclerosis (MS) it is vital to establish if short-term MRI activity is predictive of long term clinical outcome. We followed up after 5 years a group of 10 benign (relapsing-remitting MS with a disease duration 410 years and EDSS 43) and 10 early relapsing-remitting patients who previously had monthly serial MRI scans for 6 months. In the early relapsing-remitting group median EDSS at entry to the initial serial study was three and in the benign group 2.5. At 5-year follow up, five of these 20 patients had developed a definite deterioration in EDSS. The median number of new enhancing lesions detected originally in the group that had deteriorated was 11 (7-17) compared to 0 (0-5) new enhancing lesions, for those who had not deteriorated (P50.05). There was a trend towards a higher baseline T2 lesion load in the group with a definite change in EDSS but this was not significant. This study suggests that short-term measurement of the number of gadolinium enhancing lesions may predict long term outcome in relapsing-remitting MS.

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Faculty Opinions recommendation of Long-term outcome of paediatric-onset multiple sclerosis: a population-based study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717974291.793472584 ◽

2013 ◽

Author(s):

Clive Hawkins ◽

Tatiana Mihalova

Keyword(s):

Multiple Sclerosis ◽

Population Based ◽

Term Outcome ◽

Population Based Study ◽

Long Term Outcome

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